摘要
目的探讨急性中毒患者预后影响因素,为临床治疗提供指导。方法选取2011年3月—2015年3月上海市第八人民医院急诊内科收治的急性中毒182例,根据其预后情况分为存活组(163例)与死亡组(19例),采用统一设计的调查表对所有患者进行信息登记,比较两组临床特征的差异。结果存活组与死亡组性别、年龄差异无统计学意义(P>0.05),毒物接触时间、毒物类型、中毒途径、中毒原因、中毒严重程度评分、pH、二氧化碳分压、急性生理学与慢性健康状况评分系统Ⅱ评分、序贯器官衰竭评分、肌酸激酶同工酶、服毒剂量、胆碱酯酶、血液净化时间、初次用药时间及院前急救差异均有统计学意义(P<0.05,P<0.01);logistic回归分析结果表明上述15项因素均是急性中毒患者预后的独立影响因素(P<0.05,P<0.01)。结论临床应依据急性中毒患者预后的独立影响因素及时进行针对性救治,以最大限度挽救患者生命、改善预后。
Objective To discuss the influencing factors of prognosis for patients with acute poisoning in order to provide guidance for clinical treatment.Methods A total of 182 patients with acute poisoning admitted during March2011 and March 2015 were divided into the survival group（ n = 163） and mortality group（ n = 19） according to the prognosis,and the universal questionnaires were filled by all the patients to register information,and then the differences of clinical features were compared in the two groups.Results There were no significant differences in gender and age（ P〈0.05）,but there were significant differences in contact time of poison,poison type,the way and cause of poisoning,poisoning cause,poisoning severity score（ PSS）,p H,arterial carbon dioxide tension（ PaCO_2）,acute physiology and chronic health evaluation II（ APACHE II） score,sequential organ failure assessment（ SOFA） score,MB isoenzyme of creatine kinase（ CK-MB）,poison dose,cholinesterase,treatment time of blood purification,initial medication time and pre-hospital care in the two groups（ P〈0.05,P〈0.01）.Logistic regression analysis showed that the above 15 factors were independent factors affecting the prognosis of patients with acute poisoning（ P〈0.05,P〈0.01）.Conclusion Clinicians should give targeted treatment timely for patients with acute poisoning based on the independent factors of prognosis in order to save as many lives as possible and improve the prognosis.
出处
《解放军医药杂志》
CAS
2016年第5期97-100,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
关键词
中毒
急诊处理
预后
影响因素分析
Poisoning
Emergency treatment
Prognosis
Root cause analysis
